Cyclosporine A by Tandem Mass Spectrometry
Ordering Recommendation

Optimize drug therapy and monitor patient adherence.

Quantitative Liquid Chromatography-Tandem Mass Spectrometry
Within 24 hours
New York DOH Approval Status
This test is New York DOH approved.
Submit With Order
ARUP Consult®
Disease Topics
Specimen Required
Patient Preparation
Pre-dose (trough) levels should be drawn. 
Lavender (EDTA) or pink (K2EDTA). 
Specimen Preparation
Transfer 1 mL well-mixed whole blood to a plastic vial. (Min: 0.25 mL) 
Storage/Transport Temperature
Unacceptable Conditions
Serum or plasma. Specimens left at room temperature for longer than 24 hours. Clotted specimens. 
Ambient: 24 hours; Refrigerated: 2 weeks; Frozen: 2 months 
Reference Interval
Effective November 17, 2014
Therapeutic Range:
Cyclosporine A, Therapeutic Range100-400 ng/mL
Kidney transplant (in combination with Everolimus)1 month post-transplant: 100-200 ng/mL
2-3 months post-transplant: 75-150 ng/mL
4-5 months post-transplant: 50-100 ng/mL
6-12 months post-transplant: 25-50 ng/mL
Heart transplantUp to 3 months post-transplant: 350-525 ng/mL
4 months and older post-transplant: 145-350 ng/mL
Liver transplant290-525 ng/mL
Toxic valueGreater than 700 ng/mL

Interpretive Data
The general therapeutic range for cyclosporine A is 100-400 ng/mL. The optimal therapeutic range for a given patient may differ from this suggested range based on the indication for therapy, treatment phase (initiation or maintenance), use in combination with other drugs, time of specimen collection relative to prior dose, type of transplanted organ, and/or the therapeutic approach of the transplant center.

Compliance Statement B: For laboratory developed tests not using a RUO kit, and for FDA approved, cleared or 510(k) exempt assays with alterations. This test was developed and its performance characteristics determined by ARUP Laboratories. The U. S. Food and Drug Administration has not approved or cleared this test; however, FDA clearance or approval is not currently required for clinical use. The results are not intended to be used as the sole means for clinical diagnosis or patient management decisions.

Cyclosporine (Sandimmune) whole blood concentrations can be measured by either chromatographic or immunoassay methodologies. These two methodologies are not directly interchangeable, and the measured cyclosporine whole blood concentration depends on the methodology used. Reference ranges may vary according to the specific immunoassay or HPLC-MS/MS test. Generally, immunoassays have been reported to have a positive bias relative to HPLC-MS/MS assays due to the detection of antibody cross-reactivity with cyclosporine metabolites.
Hotline History
Component Test Code*Component Chart NameLOINC
0070035Cyclosporine A by HPLC-MS/MS3520-4
* Component test codes cannot be used to order tests. The information provided here is not sufficient for interface builds; for a complete test mix, please click the sidebar link to access the Interface Map.
  • Cyclosporine
  • Gengraf
  • Neoral
  • Restasis
  • Sandimmune